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Objective To determine the extent to which Black race is associated with the infant mortality rate (< 365 day, IMR) of births to US-born and foreign-born Latinx women. Methods Stratified and multivariable binominal log-linear regression analyses were performed on the 2010-2013 National Center for Health Statistics linked birth-death certificate files of singleton infants. Results The IMR of births to US-born Black Latinx women (N = 54,542) exceeded that of births to US-born White Latinx women (N = 1,320,084): 5.7/1000 vs 4.2/1000, RR = 1.4 (1.2, 1.5). In contrast, the IMR of births to foreign-born Black Latinx women (N = 35,544) approximated that of births to foreign-born White Latinx women (N = 1,372,172): 3.8/1000 vs 3.6/1000, RR = 1.0 (0.9, 1.2) The adjusted (controlling for maternal age, education, prenatal care, high parity, and region of residence) RR of infant mortality for births to US-born and foreign-born Black (versus non-Latinx White) Latinx women equaled 1.4 (1.2, 1.6) and 1.0 (0.8, 1.2), respectively. The adjusted RR of infant mortality for births to US-born and foreign-born White (versus non-Latinx White) Latinx women equaled 1.0 (0.9, 1.0) and 0.8 (0.7, 0.8), respectively. Conclusions Black race is associated with a 1.4-fold higher IMR among births to US-born Latinx women. A similar phenomenon does not occur among foreign-born Latinx women. These intriguing findings highlight that the social construct of Black race across the life-course of Latinx women are detrimental to infant outcome., Author(s): Javier Galan [sup.1] , Janardhan Mydam [sup.2] , James W. Jr Collins [sup.1] Author Affiliations: (1) grid.413808.6, 0000 0004 0388 2248, Division of Neonatology, Department of Pediatrics, Ann & [...]

Objective To examine the association between preconception diet quality, sedentary behavior, and physical activity with gestational weight gain (GWG) among Hispanic/Latina women. Methods This was a retrospective cohort study of participants from visits 1 and 2 of the Hispanic Community Health Study/Study of Latinos and singleton pregnancies between the 2 visits. Diet quality (alternative healthy eating index/AHEI-2010), sedentary behaviors, and physical activity (global physical activity questionnaire) were measured at visit 1 and accounted for preconception health behaviors. GWG was evaluated as a continuous and categorical variable according to the 2009 Institute of Medicine guidelines (inadequate, adequate, excessive). Linear and generalized logit survey regressions were used to study the association between health behaviors and GWG, using adequate GWG as the reference. Results Of the 457 women included, deliveries occurred at 3.2 years (mean) from visit 1; 48.7% of women had excessive GWG. Mean AHEI-2010 scores were < 45% for women of all Hispanic/Latina backgrounds. There was no association between each 10-unit increase in AHEI-2010 or a 500 kcal/day increase in energy intake for mean and categorical GWG. There was no association between 30 min/day higher sedentary behavior, 30 min/day higher physical activity, or meeting the 2008 US physical activity guidelines for mean and categorical GWG. Conclusions We did not find any association between diet quality, sedentary behavior, and physical activity at visit 1 with GWG in pregnancies occurring between visits 1 and 2. We noted widespread poor diet quality as measured by the AHEI-2010 and low levels of physical activity among Hispanic/Latina women., Author(s): Michelle A. Kominiarek [sup.1] , Christina Cordero [sup.2] , Alison M. Stuebe [sup.3] , Melissa Simon [sup.1] , Kelly R. Evenson [sup.4] , Krista M. Perreira [sup.5] , Linda [...]

Breast cancer is the most common cancer among Latina women, and Latina women are at higher risk for breast cancer mortality than white women. Lifestyle factors, such as consuming a nutritious diet and engaging in regular physical activity, promote health and are protective against heart disease, type 2 diabetes, and breast cancer recurrence. Previous studies have developed and tested interventions for Latina breast cancer survivors to improve diet and increase physical activity, however, no studies to date have developed a smartphone delivered intervention. The purpose of the current study was to compare two Smartphone delivered interventions, My Health, which focused on diet and physical activity, and My Guide, which focused on psychosocial functioning, on dietary and physical activity outcomes, post-intervention, and at a 2-week follow-up assessment. Overall, participants receiving the My Health intervention reported a greater reduction in daily fat sources than the My Guide group over time. However, daily sources of fat did not differ between conditions. Walking, measured by estimated weekly metabolic equivalents, increased across time points in both groups. These preliminary findings suggest that eHealth interventions aimed at improving lifestyle factors may favorably impact nutritional intake and physical activity. Future research should utilize more comprehensive and objective measures of diet and physical activity, and incorporate more behavioral lifestyle components into the intervention in larger samples with a longer follow-up period., Author(s): Joanna Buscemi [sup.1] [sup.2] , Laura B. Oswald [sup.3] [sup.4] , Sharon H. Baik [sup.3] , Diana Buitrago [sup.3] , Francisco Iacobelli [sup.5] , Siobhan M. Phillips [sup.6] , [...]

Since making its debut on the global stage in December 2019, coronavirus disease 2019 (COVID-19) has afflicted nearly 4 million people and caused hundreds of thousands of deaths. Case reports and case series depicting the clinical effects of the causative virus--severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)--have been published, yet few demonstrate the cytopathologic alterations of this disease. We present a clinical-pathologic correlation report of a previously healthy Hispanic woman with laboratory-confirmed COVID-19 who had typical features of acute respiratory distress syndrome (ARDS) and also showed cardiac abnormalities thought to represent fulminant viral myocarditis. Congruent with the ARDS clinical impression, autopsy findings were remarkable for extensive and markedly severe acute lung injury consistent with viral pneumonia, characterized by diffuse alveolar damage, pulmonary infarction, severe pulmonary edema, desquamation of pneumocytes with intra-alveolar aggregation, and pneumocyte morphologic alterations suggestive of viral cytopathic effect. However, there was incongruence between the clinical impression and the cardiovascular pathology findings in that viral myocarditis was not detected on histopathologic evaluation. This case highlights the importance of pathologic corroboration of the clinical impression and, in addition, illuminates the key role autopsy plays during a pandemic by providing valuable insight into viral pathology in tissues. (Arch Pathol Lab Med. 2020;144:1041-1047; doi: 10.5858/arpa.2020-0217-SA), The coronavims family of RNA positive-strand viruses attained global recognition with the 2002-2003 outbreak of severe acute respiratory syndrome coronavirus (SARS-CoV) in the Chinese province of Guangdong, and, later, the [...]

Introduction Obesity rates among US Hispanic women and children are high. Childhood obesity prevention beginning prenatally is desirable, but studies show mixed results. Methods We tested a pilot intervention to promote optimal gestational and infant weight with primigravid Hispanic women at a Federally Qualified Health Center (FQHC) on the U.S.-Mexico border. The intervention included promotora-led exercise, nutrition, breastfeeding activities (n = 23), supported by text/social media messaging (text messaging prenatally, private Facebook page postnatally). Measures included demographics, BMI, weight gain/retention, infant feeding, and attendance. Results Most women were U.S. born (73%), Spanish-language dominant (83%), with [less than or equal to] high school education (65%), and overweight/obese (56%). Retention rates were modest for the prenatal component (50%), supported by an SMS text-messaging program. Retention of the remaining postnatal sample, supported by a private Facebook® page, was 100%. Of women who regularly attended group sessions pre and postpartum, over 70% were within 5 lbs of pre-pregnancy weight at 6 months postpartum. A private Facebook® group was feasible for out-of-class support, including among women with regular cross-border mobility. Discussion While the intervention was well-received, almost 2/3 of the original participants did not follow up postpartum. Importantly, the findings indicate the use of social media (private Facebook® page) was more feasible than the SMS text-messaging program and may be a successful approach to reach and engage women living in mobile and transnational settings. Future studies should examine social media as an intervention tool to influence optimal weight and encourage healthy behaviors in primigravidas living near the U.S.-Mexico border., Author(s): Christine B. Williams [sup.1] , D. Yvette LaCoursiere [sup.2] , Gregory A. Talavera [sup.3] , Sheila Gahagan [sup.1] Author Affiliations: (Aff1) 0000 0004 0627 2787, grid.217200.6, Department of Pediatrics, [...]

BACKGROUND: Household cleaning products may be a significant source of chemical exposures, including carcinogens and suspected endocrine disruptors. OBJECTIVES: We characterized exposures during routine household cleaning and tested an intervention to reduce exposures to cleaning product chemicals. Methods: The Lifting Up Communities with Interventions and Research (LUCIR) Study is a youth-led, community-based intervention project. Youth researchers conducted personal air monitoring with 50 Latina women while they cleaned their homes with their regular cleaning products (preintervention visit) and then 1 week later while they used 'green' cleaning products provided by the study (postintervention visit). Air samples were analyzed for volatile and semivolatile organic compounds using gas chromatography-mass spectrometry and high- performance liquid chromatography. We compared pre- and postintervention air concentrations of 47 chemicals of concern, selected because they were on California's Proposition 65 list of carcinogens or reproductive/developmental toxicants or were suspected endocrine disruptors. Youth researchers were integrally involved in the study design, data collection, interpretation, and dissemination of findings. RESULTS: We observed statistically significant decreases in air concentrations of 17 chemicals of concern when participants switched to green cleaning products, including decreases in geometric mean concentrations of 1,4-dioxane (-46.4%), chloroform (-86.7%), benzene (- 24.8%), naphthalene (-40.3%), toluene (-24.2%), and hexane (-35.5%). We observed significant increases in air concentrations of three fragrance compounds: the plantderived terpene, beta-myrcene (221.5%), and the synthetic musks celestolide (31.0%) and galaxolide (79.6%). Almost all participants (98%) said the replacement products worked as well as their original products, and 90% said that they would consider buying the replacement products in the future. DISCUSSION: This study demonstrates that choosing cleaning products that are marketed as green may reduce exposure to several carcinogens and endocrine disruptors. Future studies should determine whether use of unscented green products would further reduce exposure to terpenes and musks. https://doi.org/10.1289/EHP8831, Introduction Household cleaning products can expose consumers to multiple chemicals, including volatile organic compounds (VOCs) that may affect human health. Multiple studies have shown associations of cleaning products with increased [...]

Introduction Hispanic immigrants are more likely to breastfeed than are Hispanics born in the US, in part due to their acculturation. This paper aims to systematically review the existing literature on the association between acculturation and Hispanics' breastfeeding behaviors. Methods The systematic search used major databases such as Medline and PubMed, and it followed the PRISMA checklist. The scientific quality of the studies was rated using the Quality Assessment Tool for Quantitative Studies. Results We identified 1943 potential citations, of which 18 studies met the eligibility criteria. Overall, while 13 studies suggested that high-acculturated Hispanics were less likely to breastfeed compared with low-acculturated, five studies did not find significant evidence of such an association. Moreover, 12 studies used a static measure or a linear scale, which is not optimal; only three studies utilized bi/multidimensional scales to assess acculturation. Intention to breastfeed was examined in six studies, but the results were inconsistent. Breastfeeding initiation was examined in 11 studies, and two out of eight studies that examined breastfeeding duration, specifically analyzed exclusive breastfeeding at 6 months. Discussion Our results agree with the general hypothesis that higher acculturation is inversely related to breastfeeding rates, independently of income. Researchers used different methodologies to study acculturation and breastfeeding practices, limiting our ability to reach more detailed conclusions. Owing to the lack of a standard methodology for measuring acculturation, future studies should utilize bi/multidimensional scales when studying breastfeeding, in particular, in relation to breastfeeding intention and exclusive breastfeeding at 6 months; preferably according to Hispanic subgroups., Author(s): Galya Bigman [sup.1] , Anna V. Wilkinson [sup.1] , Adriana Pérez [sup.2] , Nuria Homedes [sup.3] Author Affiliations: (Aff1) 0000 0000 9206 2401, grid.267308.8, Epidemiology, Human Genetics and Environmental [...]

Zisteria monocytogenes is a widely distributed environmental bacterium that can grow at refrigeration temperatures. Infection can cause severe illness and death. Persons at higher risk for infection include older adults, [...]

U.S. life expectancy plummeted nearly two years the first year of the COVID-19 pandemic, according to new data from the Centers for Disease Control and Prevention. In a December brief [...]

The objectives of this study were to describe gestational weight gain (GWG) trends and identify predictors of GWG among WIC participants in Southern California, 84% of whom are Hispanic. Using descriptive statistics and multiple logistic regression, we examined WIC data on 23,840 Hispanic women with full term pregnancies who enrolled in WIC at first trimester and had their last prenatal WIC visit within 1 month or less of their delivery date. Overall, 23.9% of women exceeded IOM recommendations. Among Hispanic English speakers (HES), 30% exceeded IOM recommendations compared to 18.7% of Hispanic Spanish speakers (HSS). Among Hispanic mothers who are less than 20 years of age, 28.9% exceeded IOM guidelines compared to 19.8% of Hispanic mothers 35 or older. Among those who started pregnancy overweight or obese, 30.5% exceeded IOM recommendations versus 12.1% of those with normal BMI. Multiple logistic regression showed that the odds of exceeding the IOM recommendations were 42% lower for HSS versus HES, decreased by 2% for every 1 year increase in age, and increased by 5% for every one unit increase in BMI at first trimester. Poverty level and health care coverage were also significant predictors of GWG. Given the wide reach and high quality of height/weight measurements taken by the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Program, WIC administrative data have significant potential to help fill the existing gaps in GWG surveillance, a much needed step for forming policy and designing effective interventions. Keywords Gestational weight gain * GWG surveillance * Hispanic women * WIC, Introduction Excessive gestational weight gain (GWG) is linked to several maternal and infant adverse health outcomes including large-for-gestational age infants, caesarean delivery and maternal weight retention postpartum [1]. There is [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2009.03.013 Byline: Donna Spruijt-Metz, Britni Belcher, David Anderson, Christianne Joy Lane, Chih-Ping Chou, Dawna Salter-Venzon, Jaimie N. Davis, Ya-Wen Janice Hsu, Marian L. Neuhouser, Joyce M. Richey, Thomas L. McKenzie, Arianna McClain, Michael I. Goran, Marc J. Weigensberg Abstract: Acute effects of high-sugar/low-fiber meals vs low-sugar/high-fiber meals on hormones and behavior were studied in 10 overweight Latina females, age 11 to 12 years, using a crossover design. In this exploratory pilot study, participants arrived fasted at an observation laboratory on two occasions and randomly received either a high-sugar/low-fiber meal or a low-sugar/high-fiber meal at each visit. Glucose, insulin, and leptin were assayed from serum drawn at 0, 15, 30, 60, 90, and 120 minutes. Ad libitum snacks were provided at 120 minutes. Physical activity was measured using an observational system that provides data on time spent lying down, sitting, standing, walking, and in vigorous activity. Data were collected between March 2005 and July 2006. In the high-sugar/low-fiber condition, glucose and leptin levels decreased more slowly, glucose levels were higher at 60 minutes (111.2 mg/dL vs 95.4 mg/dL, P=0.03), and leptin levels were higher at 90 minutes (49.3 ng/mL vs 46.7 ng/mL, P=0.017) than in the low-sugar/high-fiber condition. Meals did not affect insulin or ad libitum dietary intake. Sitting, standing, lying down, and vigorous activity differed by condition, but not walking. Participants were significantly more active in the first 30 to 60 minutes after the high-sugar/low-fiber meal, but after 60 minutes there was a trend for activity to be lower after the high-sugar/low-fiber meal vs the low-sugar/high-fiber meal. High-sugar meals sustain glucose and leptin levels longer, which may play an important role in modulating levels of physical activity in this group at high risk for obesity-related disease. Article History: Accepted 12 December 2008

In an effort to discover what can improve family planning services for recently immigrated Hispanic women and to foster cultural competence among health care providers in this arena, the authors conducted four focus groups of recently immigrated Hispanic women in a medium-sized Midwestern community. The focus group discussions covered such topics as health care, knowledge of birth control, domestic life, and economic issues in the United States. The participants demonstrated knowledge of and support for the concept of family planning and specific birth control methods. They also identified issues that challenge the use of birth control at the individual, family, system, and cultural levels. Keywords: family planning; focus groups; Hispanic women; immigrants

Objectives. We explored whether higher levels of acculturation were associated with higher rates of cigarette smoking among pregnant Hispanic women residing in the United States. Methods. We evaluated data from the Latina Gestational Diabetes Mellitus Study, a prospective study of 1231 Hispanic prenatal care patients conducted from 2000 to 2004 in Massachusetts. Self-reported data on acculturation, cigarette smoking, and covariates were collected by bilingual interviewers using a questionnaire. We conducted logistic regression multivariate analyses to examine the impact of acculturation level on the odds of smoking. Results. Overall, 21% of women reported smoking during pregnancy. Acculturation was associated with elevated smoking rates in pregnant Hispanic women. US-born Hispanic women who preferred English had more than twice the odds of smoking compared with Puerto Rican or foreign-born Hispanic women who preferred Spanish (odds ratio [OR]=2.76, 95% confidence interval [CI] 1.36, 5.63). Conclusions. Our findings suggest that higher-acculturated Hispanic women living in the United States are more likely to smoke cigarettes during pregnancy than are less-acculturated Hispanic women. These results will inform interventions aimed at reducing cigarette smoking during pregnancy among US Hispanic women. (doi:10.2105/AJPH.2006.095505)

This study compares demographic characteristics, sexual risk factors for HIV/STI, and cultural predictors of sexual risk among 254 Dominican and 1,012 Puerto Rican women using outpatient health care in New York City. More Dominicans were born outside continental United States and were employed, whereas more Puerto Ricans were single and less educated. Both groups of Latinas exhibited low condom use with main and other sexual partners, perceiving their own and their partners' risk as low. Puerto Ricans were more heterosexually active, had more sexual partners, had higher incidence of STI and HIV than Dominicans. However, Puerto Rican women were more likely to use condoms with a sexual partner. Significant differences in sexual risk support the design of ethnically tailored HIV prevention interventions. Keywords: Dominican women; Puerto Rican women; sexual risk; HIV/AIDS; sexually transmitted infection (STI)

This project examined differences in health history, eating and activity behaviors, and biomarkers across three weight categories of rural, Midwestern, US-born Hispanic women as a way to identify critical factors for improving long-term health. Using a cross-sectional descriptive design, a convenience sample of 70 women, aged 19 to 69 years, completed general health, demographic, food frequency, and physical activity questionnaires. Height, weight, blood pressure, and waist circumferences were measured and recorded. One-way analyses of variance and [chi square] analyses were completed. Differences in the presence of diabetes and hypertension were demonstrated across the weight categories. In all three weight categories, fat intakes exceeded and fruit, vegetable, and dairy intakes were below current recommendations. Higher mean daily grain food intake was found for women of normal weight compared to overweight women (7.1 [+ or -] 5.5 vs 3.6 [+ or -] 2.3 servings, respectively, P = 0.01). A greater proportion of normal-weight women (61.9%) met the targeted physical activity level compared to overweight (42.9%) and obese (21.4%) women ([chi square] = 8.29, P = 0.016). Because differences in physical activity rather than energy intakes might be a source of energy imbalances that affect weight, additional work to identify behavioral determinants that promote adoption of healthful activity behaviors will be a key component in designing effective educational strategies for these Hispanic women.

As part of a broader study aimed at evaluating perceived alliance with service providers and level of satisfaction with services received, 103 monolingual Spanish speaking Hispanic women were interviewed. Participants were receiving ongoing behavioral health treatment at three different community service provider sites located in the greater New Haven area in Connecticut. These sites included a community health center (n = 40), a community behavioral health center (n = 40), and a faith-based agency (n=23). As part of this study, the English version of the Therapeutic Alliance with Clinician (TAC) questionnaire was translated into Spanish and administered to our sample of Hispanic women. Results on the psychometric properties of the Spanish version of the TAC are presented in this article. KEY WORDS: behavioral health, community, Hispanic, relationship, therapeutic alliance

This study examined program attendance and related outcomes for Companeros en la Salud, a church-based culturally focused health promotion program specifically designed for low-acculturated, low-income Hispanic women. In this church-based study, the cancer prevention intervention was the major intervention group, and its effects were compared with a noncancer-oriented family mental health group. The goal of the present study was to identity predictors of program attendance and increases in cancer prevention knowledge and behaviors. Lower levels of acculturation level and greater overall church attendance were predictive of program attendance for Hispanic women in the cancer prevention component. Also, attendance in the cancer intervention component of the Companeros en la Salud program was predictive of posttest cancer prevention knowledge. By contrast, higher acculturation level was a significant predictor of having had a clinical breast exam at posttest. Similarly, younger age and lower fear of cancer were predictive of having had a pap smear at posttest. Finally, pretest cancer prevention knowledge was a significant predictor of mammography screening for women ages 40 and over. These results offer implications for the development of culturally tailored cancer prevention programs for Hispanic women. KEY WORDS: Latinas; cancer prevention program; Promotoras; acculturation.

The Formando Nuestro Futuro/Shaping our Future project (herewith, Formando) is a community-based participative research (CBPR) focused on type 2 diabetes. It was conceptualized and designed by a team of university-based researchers and community health workers (promotores). This article describes the process of establishing a CBPR project such as Formando and the most current results from that project. The Formando project is an example of health-focused advocacy with the Mexican agricultural workers in Southeast (SE) Idaho. To date, 172 qualitative interviews on participants' knowledge about type 2 diabetes have been carried out with farmworker women and their families. Biometric data (heights, weights, blood pressures and lasting blood glucoses) were obtained from participants. Fieldnotes, focus group discussions and key informants were used to triangulate findings. Significant quantitative findings include that age was significantly associated with Body Mass Index (BMI) (p < 0.001, Spearman Correlation < 0.001 ) and with elevated fasting blood glucose (p < 0.001, Spearman Correlation < 0.001). The qualitative interviews were thematically analyzed. Key themes associated with type 2 diabetes in this community were the connection between thinness and vanity, dieting and starvation and the onset of diabetes as a result of, what social scientists call, structural violence within the immigrants' daily lives. We conclude that long-term commitment to using the CBPR approach in these Mexican agricultural communities is an effective way to engage in health research and to establish real and meaningful dialogue with community members. KEYWORDS. Community-based participatory research (CBPR), advocacy, Hispanic farmworkers, type 2 diabetes, community health workers (CHWs)

Objectives: We investigated how couples' immigration status and ethnicity determined the decision to initiate breast-feeding and to breastfeed at 6 months. Methods: From data collected on 4207 mothers and 3013 fathers participating in a longitudinal birth cohort study, we used linear regression and covariate-adjusted proportions to estimate the determinants of breastfeeding behaviors. The sample was divided by immigration status (either foreign born or born in the United States) and further subdivided by ethnicity (Mexican Hispanic, non-Mexican Hispanic, and non-Hispanic). Results. Mothers born in the United States had an 85% reduction in the odds of breastfeeding as compared to foreign-born mothers and a 66% reduction in the odds of breastfeeding at 6 months. Each additional year of US residency decreased the odds of breastfeeding by 4%. These differences by immigration status were seen for Mexicans, other Hispanics, and non-Hispanics. Conclusion: The Hispanic paradox may extend to other non-Hispanic immigrants for breastfeeding behaviors, but may not be true for Hispanic mothers born in the United States. Low rates of breastfeeding for Hispanic American mothers indicate that they should not be overlooked by breastfeeding promotion programs. doi:10.2105/AJPH.2005.064840)

Studies have reported discrepant findings about the relationship between acculturation and mental health, often because of inattention to interethnic group differences. This 2003 exploratory study of various Latina ethnic groups attending the Women, Infant, and Children (WIC) Program compared five measures of acculturation and mental health status/utilization. The subgroups differed on language, immigration/migration history, and the prevalence of anxiety attacks and depressive syndrome. The prevalence of anxiety attacks was the highest among those who spoke primarily Spanish, the prevalence of the depressive syndrome was the highest among those with more traditional beliefs, and the use of mental health services was the highest among those with less traditional beliefs. Implications for practice are discussed. Keywords: acculturation; Latinas; mental health; women

Unintended pregnancy disproportionately affects Latina women. One factor contributing to unintended pregnancy among Latinas is the low rate of contraceptive use. This study examined correlates of effective contraceptive use among a sample of Latina women (n = 202) at increased risk for HIV. In addition to traditional intrapersonal variables (i.e., perceived risk of pregnancy, motivation to avoid pregnancy), the present study examined the role of the male partner and relationship factors (i.e., relationship commitment, duration, pregnancy prevention decision-making) on contraceptive use. Participants were recruited from clinics and community locations in East Los Angeles and administered a 60-minute in-person interview. Multivariate logistic regression was used to compare women who consistently used effective contraceptives (36%) to women using no method or an ineffective method. Women in relationships of 1 to 2 years were nearly 3 times more likely to use an effective contraceptive compared to women in relationships of less than 1 year (odds ratio (OR) = 2.7, 95% CI 1.1, 6.7). Women were more than twice as likely to use an effective method if they reported a high level of involvement in decision-making about whether to use contraception (OR = 2.3, 95% CI 1.1, 4.7) or had discussed contraception with their partner (OR = 2.4, 95% CI 1.03, 5.6). This study provides additional information about the importance of male partners and relationship factors in contraceptive use among Latina women. Efforts to prevent unintended pregnancy need to address the role of relationship factors in the sexual risk and protective behaviors of Latinas. doi: 10.1300/J013v43n02_01 [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: KEYWORDS. Contraception, Latina women, relationship characteristics, intrapersonal factors

The purpose of this investigation was to assess the knowledge, attitudes, and perceptions about breast cancer, and screening behaviors among Hispanic women in Pennsylvania. Eight focus groups were conducted with Hispanic women to obtain answers to the questions of interest. Results, based on content analysis, showed that cultural factors, such as family and fatalism, influence breast cancer knowledge and screening among this group. In addition, these women had some misconceptions regarding breast cancer and breast cancer detection screening. Most participants reported that they would like to receive breast cancer education in Spanish from health care providers or health educators. These results can help health professionals, including health educators, in the development of suitable breast cancer education and screening promotion programs for Hispanic women. KEY WORDS: breast cancer; knowledge; perceptions; Hispanic.

Objective To examine the influence of meal decision-making and preparation on Hispanic women's dietary practices. Design One-on-one structured interviews were conducted, assessing meal decision-making and preparation practices, barriers, and behavioral strategies to eating low-fat and high-fiber diets, fat and fiber intake, demographic, and other psychosocial factors. Subjects/setting The study population included 357 Hispanic women living in the southern or central regions of San Diego County. Participants were recruited via random-digit dialing to a tailored nutrition communication intervention. Main outcome measure Household decision-making style (alone vs with family) by household activity (decides meals, prepares meals, and decides snacks). Statistical analyses performed Multiple logistic regressions were used to evaluate associations between the predictors and dependent variable. All models included adjustments for potential confounders, such as marital status, education, employment, age, and acculturation. Results A positive statistical association between Hispanic women's acculturation level and shared decision-making style was found. Also, Hispanic women in shared decision-making households faced greater psychosocial barriers to healthful eating and reported less healthful eating compared with Hispanic women in traditional house-holds. Women in shared decision-making households were more likely to eat at fast-food restaurants, less likely to engage in behavioral strategies promoting fiber consumption, eat more saturated fat, and encounter more barriers to reduce dietary fat as compared with Hispanic women in traditional households. Acculturation did not attenuate differences in psychosocial and dietary practices between shared decision-making and traditional households. Conclusions Study findings suggest intervention efforts should focus on different aspects of healthful eating among Hispanic women in shared-decision, compared with traditional, households. J Am Diet Assoc. 2006;106:38-45.

Byline: Jennie C. Leslie (1), Sandra J. Diehl (2), Shelley L. Galvin (1,3) Keywords: birth outcomes; Hispanic; ethnicity; birth certificates; NC vital statistics Abstract: Objective: To compare birth outcomes between non--US-born and US-born Hispanic women in North Carolina (NC). Methods: A retrospective comparison of birth outcomes from linked NC birth/death certificate data (1993--1997) for 22,234 Hispanic births by mother&apos;s place of birth was conducted. Results: Mexico-born Hispanic women (58%) had significantly fewer medical risks, tobacco or alcohol use during pregnancy however, they also had significantly less education and prenatal care than US-born Hispanic women (21%). Infant mortality rate, low birth weight, and prematurity were low and did not differ significantly. Lethal anomalies were the primary cause of infant mortality in non--US-born Hispanics versus Sudden Infant Death Syndrome (SIDS) in US-born Hispanics. Conclusions: Despite increased risk factors among US-born women, we found no difference in Hispanic birth outcomes in NC by mother&apos;s place of birth. These data contradict national data and may be related to findings of both positive and negative aspects of acculturation in NC. Author Affiliation: (1) MAHEC Department of Obstetrics and Gynecology, Asheville, North Carolina, USA (2) Coastal AHEC, Research Department, Wilmington, North Carolina, USA (3) MAHEC Department of Obstetrics and Gynecology, 93 Victoria Road, Asheville, North Carolina, 28804, USA Article History: Registration Date: 23/08/2005 Online Date: 13/12/2005

Byline: Pamela L. Thornton (1,8), Edith C. Kieffer (2), Yamir Salabarria-Pena (3), Angela Odoms-Young (4), Sharla K. Willis (5), Helen Kim (6), Maria A. Salinas (7) Keywords: Social support; pregnancy; Latinas; diet and weight; physical activity. Abstract: Objectives: Eating and physical activity patterns may contribute to excessive pregnancy weight gain and postpartum retention that increase the risks of obesity and diabetes for both Latino mothers and their children. Social support is an important health determinant and may affect health-related beliefs and behaviors. The objective of this study was to investigate the influence of social support on weight, diet, and physical activity-related beliefs and behaviors among pregnant and postpartum Latinas. Methods: A community-based participatory project, Promoting Healthy Lifestyles among Women, was conducted in southwest Detroit to plan interventions aimed at reducing risks of obesity and type 2 diabetes. Qualitative analyses of in-depth semistructured interviews with dyads of 10 pregnant and postpartum Latinas, and 10 people who influenced them were conducted. Results: Husbands and some female relatives were primary sources of emotional, instrumental, and informational support for weight, diet, and physical activity-related beliefs and behaviors for Latina participants. Holistic health beliefs and the opinions of others consistently influenced Latinas&apos; motivation and beliefs about the need to remain healthy and the links between behavior and health. Absence of mothers, other female relatives, and friends to provide childcare, companionship for exercise, and advice about food were prominent barriers that limited women&apos;s ability to maintain healthy practices during and after pregnancy. Conclusion: The findings support evidence that low-income, recently immigrated pregnant and postpartum Latinas could benefit from community-based, family-oriented interventions that provide social support necessary to promote and sustain healthy lifestyles. Author Affiliation: (1) Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA (2) University of Michigan School of Social Work, 1080 S. University, Ann Arbor, Michigan, USA (3) Health Services Research and Evaluation Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA (4) Public and Community Health Program, Northern Illinois University School of Allied Health, Dekalb, Illinois, USA (5) Ohio State University School of Public Health, Columbus, Ohio, USA (6) University of Michigan School of Social Work, 1353 West Winona, Unit 1, Chicago, Illinois, USA (7) University of Michigan School of Public Health, Ann Arbor, Michigan, USA (8) W.K. Kellogg Foundation Scholar in Health Disparities, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, 48106-1248, USA Article History: Registration Date: 23/08/2005 Online Date: 14/03/2006

An evaluation of pesticide use data and breast cancer incidence rates in California Hispanic females was conducted via a regression analysis. The analysis used 1988-2000 data from the California Cancer Registry, the population-based cancer registry that monitors cancer incidence and mortality in California. It also used pesticide use data from 1970-1988 from the California Department of Pesticide Regulation. California is the leading agricultural state in the United States, and more than a quarter of all pesticides in the United States are applied there. Hispanic (Latina) females are commonly employed in agricultural operations. The authors performed regression analysis of county-level specific pesticide use data (pounds of active ingredients applied) for two classes of pesticides, organochlorines and triazine herbicides, against the breast cancer incidence rates among Latinas, controlling for age, socioeconomic status, and fertility rates, using negative binomial regression models. A total of 23,513 Latinas were diagnosed with breast cancer in California during the years 1988-1999. Risk of breast cancer was positively and significantly associated with age and socioeconomic status, and inversely and significantly associated with fertility levels. With respect to pesticides, breast cancer was positively associated with pounds of the organochlorines methoxychlor (adjusted incidence rate ratio [IRR] for highest quartile = 1.18; confidence interval [CI] = 1.03-1.35) and toxaphene (IRR = 1.16; CI = 1.01-1.34). No significant associations were found for the triazine herbicides atrazine and simazine., Introduction Hispanic (Latina) females experience lower risk of breast cancer than do non-Hispanic white women. In California, the age-adjusted breast cancer incidence rate in 1999 among Latinas was 84.9/100,000, while [...]

Colorectal cancer (CRC) is the second most common cancer among Latinos; screening can reduce mortality from CRC. The aims of this study are; to assess the current compliance with free [...]

Lack of time is a well-known barrier to physical activity. It is not known, however, whether this barrier reflects actual time commitments. This study examined time commitments of women and assessed the relationship between time commitments and perceived lack of time for physical activity. Participants were 249 African American and Hispanic women, aged 45 to 70 years. These women devoted much of their time to their responsibilities as workers, housekeepers, mothers and wives. They also spent 28 hours per week in sedentary leisure-time activity. Actual time commitments did not predict perceived lack of time for physical activity. These findings can be used to address the misperceptions of women about time available to them for physical activity. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: KEYWORDS. Exercise, correlates, health promotion, barriers

IN ADDITION to the information on overall U.S. deaths, NCHS released new data on maternal mortality for the first time in more than a decade. While the new statistics showed [...]

Violence is a significant health issue for Latinas in the United States (US), with 54.9% reporting violent victimization. However, little is known about battering among Hispanic women in the southeast. The southeastern corridor, a rural area in search of cheap labor, is a magnet for undocumented agricultural workers. The purpose of this study was to describe domestic violence in Hispanic/Latino women in the southeastern US, including type and frequency of violence experienced, barriers to obtaining treatment, and services needed by women who have been abused. Hispanic women completed questionnaires developed from information from focus groups. Results indicate that domestic violence is a major health problem for women in the southeast, and document previous findings as well as offer new insights about Hispanic women who have experienced domestic violence. Implications are discussed in terms of the need for community partnerships and interventions, as well as routine screening and crisis intervention. KEY WORDS: domestic violence; Latinas; Hispanic; survey; needs., INTRODUCTION The United States Department of Justice estimates that 4.5 million women are violently victimized in the United States (US) every year (US Department of Justice, 1998). Clinical data indicate [...]

Purpose: Few empirical studies have compared the efficacy between psychoeducational (skill-building) approaches for reducing caregivers' psychological distress and interventions modeled after typical community-based support groups. We compare the impact of two distinct interventions on Anglo and Latino caregivers of elderly relatives with dementia. Design and Methods: The change from preassessment to postassessment (baseline to 3 months) for 213 female caregivers (122 Anglo and 91 Latino) is presented. They were seen weekly for 10 weeks in either the Coping With Caregiving psychoeducational program (instruction and practice in small groups to learn specific cognitive and behavioral skills) or in the Enhanced Support Group condition (guided discussion and empathic listening to develop reciprocal support within the group). Both programs were tailored to be sensitive to the cultural concerns of Anglo and Latino caregivers, and they were delivered in either English or Spanish by trained interventionists. Results: Overall, participants in the Coping With Caregiving condition reported a significant reduction in depressive symptoms, increased use of adaptive coping strategies, and a trend toward decreased use of negative coping strategies when compared with those in the Enhanced Support Group condition. Results were similar for both ethnic groups: there were no main effects for ethnicity, and no significant ethnicity by treatment interaction effects. Implications: This study provides empirical support that female caregivers benefit more from a skill-building approach to managing their distress than from support group membership alone. We find it very encouraging that the Latino caregivers responded well on key outcome variables, suggesting that Latinos will participate in clinical research and will benefit from their involvement when services are provided to meet their specific needs. Key Words: Alzheimer's caregiving, Interventions, Latino issues, Coping

Prenatal care health promotion education is an important strategy for reducing perinatal health disparities. The purposes of this study were to (a) identify differences between the health promotion content women wanted to discuss and the content women reported discussing and (b) determine whether ethnicity was related to health promotion content. A cross-sectional study used face-to-face interviews to obtain data about 159 Mexican American and African American pregnant women's prenatal experience. Women wanted more health promotion content than they discussed. Despite wanting information about more health promotion topics than African American women, Mexican American women discussed fewer topics. Ethnicity, number of topics women wanted to discuss, whether a woman had a primary provider, and type of prenatal provider model were also related to content. Keywords: prenatal care; health promotion; ethnic disparities; quality of care

Objectives. We investigated hysterectomy prevalence among Hispanic women. Methods. We obtained data from 4684 Hispanic women and 20604 non-Hispanic White women from the 1998-1999 National Health Interview Survey. We calculated nationally representative odds ratios of previous hysterectomy, controlling for confounders. Results. Compared with non-Hispanic White women, the odds ratio for hysterectomy was 0.36 (95% confidence interval [CI] = 0.30, 0.44) for Hispanic women with no high school diploma, 0.57 (95% CI=0.44, 0.74) for high school graduates, and 0.67 (95% CI=0.42, 0.87) for college attenders. Country of origin had little influence on hysterectomy prevalence. Hysterectomy was positively associated with acculturation. Conclusions. Hispanic women undergo fewer hysterectomies than do non-Hispanic White women. The reasons for this, as well as information on ethnicity-specific appropriateness of hysterectomy, should be explored.

Evidence of the benefits of physical activity in the health of aging women continues to grow, but questions remain about the factors that influence these women's ability to engage in this behavior. The authors used a qualitative design to describe the social and culture-specific perceived benefits and barriers to physical activity among 143 Latina women, ages 40 to 79. Content analysis of these women's responses revealed that perceived benefits (health promotion, physical fitness, improved roles) and barriers (time constraints of women's roles, personal health, internal and external factors) function as competing elements that may explain physical inactivity among aging Latina women. This emphasis holds promise as a feasible and effective primary care intervention for achieving increased physical-activity-related health benefits.

According to national surveillance studies, participation in leisure-time physical activity remains low among minority women. Furthermore, the correlates of such activity in this group are not well understood. To better understand the environmental, policy, and sociocultural correlates of physical activity among Latina immigrants, six focus groups were conducted in rural North Carolina. Among the 49 participants, median age was 32 years and median education 11 years. Participants were first generation immigrants from Mexico (n = 43), El Salvador (n = 3), Colombia (n = 1), the Dominican Republic (n = 1), and Honduras (n = 1). Environmental and policy barriers to activity were identified, including transportation, lack of facilities, cost, and safety. Sociocultural correlates of activity included gender roles for activity, importance of support from the family and husband, child care issues tied to having few relatives who lived close by, language, and isolation in the community. The women suggested changes and programs that could promote physical activity through multiple channels, especially involving the family. This information can be used to develop culturally appropriate interventions to increase physical activity among Latinas. KEYWORDS. (MeSH terms): Emigration and immigration, exercise, focus groups, Hispanic Americans, leisure activities, women

INTRODUCTION The rate of HIV infection is increasing rapidly among women of color, particularly African American women and Latinas. Recent statistics indicate that among people with AIDS in the United […]

Much of the research on women's health has not deepened our understanding of health issues affecting Latinas. Yet integration of research on Latinas into the women's health agenda is important for at least 2 reasons. First, critical public health issues facing Latinas must be better understood if effective interventions designed to eliminate racial and ethnic disparities in health are to be developed and implemented. Second, studies on the health of Latinas represent unique opportunities to advance scientific understandings of underlying processes relevant to the health of other populations. Such research can further our knowledge of the processes underlying cultural adaptation and negotiation of changing sex roles and how these issues affect the health of women. Critical research and empirical approaches that help us to understand how race, ethnicity, sex, and class shape the health of Latinas will inform broader public health issues.

This paper discusses the results from the field test of a multimedia health education intervention, designed to provide breast cancer education for low income Latinas. The purpose of the field test was to ascertain whether the intervention produced significant changes in breast cancer knowledge and attitude, and screening intentions. A total of 1197 Latina women participated in the field study at six different sites. The majority of the participants were under 65 years of age, foreign-born with less than eight years of education and a weekly household income that fell in the lowest income quintile for 1998 (<$350.00). Participants were randomly assigned to a control or intervention condition. The control group was interviewed about their breast cancer knowledge, attitude and mammography intentions prior to exposure to the intervention, and served as the baseline group. Women in the intervention group exhibited higher knowledge scores than the pretest group (Chi sq., p [less than or equal to] 0001). Never-screened women exhibited the largest differences in knowledge scores relative to the baseline sample. The intervention also increased the likelihood of women seeking information about a mammogram. KEY WORDS: Latinas; Hispanic women; multimedia; breast cancer; mammography.

Obesity, a major public health problem among U.S. Hispanic women, has a psychosocial cultural context, which we explore through quantitative and qualitative methods. We examine, e.g. paid and unpaid work, cultural and familial dynamics, and their relation to eating habits, BMI and general well-being. Twenty-three Hispanic mothers mainly born in Mexico participated. Over half were obese and had less than 8 years of schooling. Multivariate predictors of BMI were 'unrewarding' meal-related family behaviors and negative attributes of the children. Language discrepancy (Spanish predominance for the mother, but English spoken in the home) was sharpest among those with lowest SES, and was significantly correlated with unrewarding meal-related behaviors, poor self-assessed health, and borderline significantly with BMI. Low SES, social isolation and heavy burden of preparing meals, were inter-correlated and each directly associated with low self-esteem and indirectly, with obesity.

In a survey of 154 Latina AIDS caregivers living in Los Angeles, we examined differences in the stress process for those who were HIV seropositive, seronegative, and those with an unknown serostatus. Most caregivers were monolingual, poor, suffered from chronic physical illness unrelated to HIV, and received few services. All three subsamples reached clinical cut-off levels for depression on the brief symptom inventory. In the sample as a whole and in all three groups we examined differences in primary and secondary stressors as predictors of mental and physical well-being; differences in background factors as they relate to mental and physical well-being; and differences in predictive value of various factors that may attenuate the relationship between stress and mental and physical well-being. Models predicting both mental and physical well-being differ across subsamples divided on the basis of serostatus. Based on these findings, we discuss implications for service provision designed to target these underserved Latina AIDS caregivers. Keywords: HIV/AIDS; Caregivers; Latino; Hispanic; Stress; Depression; USA

Objectives. This study analyzed changes in the financing of prenatal care and delivery, the use of prenatal care, and birth outcomes among foreign-born vs US-born Latino women following enactment of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) in August 1996. Methods. We used a pre-post design with a comparison group. The sample consisted of resident Latinas in California, New York City, and Texas who delivered a live infant in 1995 or 1998. Results. The proportion of births to Latinas that initiated prenatal care in the first 4 months of pregnancy increased for all foreign-born Latinas in California, New York City, and Texas between 1995 and 1998 (P Conclusions. There are little evidence from vital statistics in California, New York City, and Texas that PRWORA had any substantive impact on the perinatal health and health care utilization of foreign-born relative to US-born Latinas. (Am J Public Health. 2001;91:1857-1864)

A sample of African-American, Latina and White women in LA were surveyed to analyse the links between economic, social and structural factors and HIV-related risk taking. The findings show distinct differences in the ethnic communities influenced by the nature of the family and the economic position of the women. African-American women faced increased risk because of economic instability which led them to sex outside their primary relationships. Latina women in committed relationships faced risk influenced by the sexual history of their partners. The sexual practices of White women increased their risk.

Byline: Arden Handler (1), Deborah Rosenberg (1), Timothy Johnson (2), Kristiana Raube (3), Michele A. Kelley (1) Keywords: Medicaid; managed care; African-American women; Latina women; recruitment of pregnant women; low-income pregnant women; prenatal care providers Abstract: Objectives: This study describes the use of a Medicaid managed care list to prospectively recruit into a research project pregnant women receiving care from a variety of providers. Method: A list of women enrolled in Medicaid managed care was used to recruit pregnant African-American and Latina women into a study of prenatal care satisfaction. Due to privacy concerns, the researchers were not able to directly access names from the list. Instead, a managed care contract agency sent recruitment letters to 1009 pregnant African-American and Latina Medicaid recipients. Response rates by ethnicity and several other key variables are calculated. The biases associated with this method of recruiting pregnant women from a variety of providers are discussed. Results: Thirty-five percent of the women contacted returned consent forms and agreed to have researchers approach them the response rate for African-American women was 43% and for Latinas was 29% (p &lt 0.0001). Respondents were younger and later in their pregnancies than nonrespondents, but did not differ from them by zip code of residence. The women recruited into the study obtained prenatal care from a diverse group of providers. Conclusions: While the use of a prospectively generated list of pregnant Medicaid recipients to recruit low-income pregnant women into a research study may be associated with some selection bias, the potential cost savings, decreased effort, and diminished recall bias may make their use a feasible sampling alternative, particularly when the researcher desires to recruit women seeking care from a variety of provider arrangements. Author Affiliation: (1) University of Illinois School of Public Health, Chicago, Illinois (2) University of Illinois Survey Research Laboratory, Chicago, Illinois (3) University of Chicago, Center for Health Administration Studies, Chicago, Illinois Article History: Registration Date: 19/09/2004

Dr. Fulton is Chief of Health Promotion, Rhode Island Department of Health, and Clinical Assistant Professor of Community Health, Brown University, Providence, RI. Dr. Rakowski is Assistant Professor of Community […]